For my Capstone project, I conducted a qualitative phenomenological research study on the lived experiences of "nurse practitionering" from the perspective of practicing nurse practitioners. The study involved extensive research, approval by the Internal Review Board (IRB) of Sacred Heart University (SHU), recruitment of participants and collection of data. A total of eight NPs were interviewed, the recordings were transcribed verbatim and extensively analyzed for recurring themes. The data findings were articulated into a manuscript for submission to a professional journal. The manuscript was recently submitted to The Journal of the American Association of Nurse Practitioners (JAANP) and is currently under review. The project won an award for "Outstanding Master's Capstone Project" and the findings were presented at a Poster Presentation at SHU. Below is a picture of the poster.
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Nursing scrubs are wonderful. When I was in nursing school, my uniform was a bright white dress. It had two front pockets, was uncomfortably stiff and scratchy, and was very hard to work in. Paired with bright white stockings and white nursing shoes, I felt like I practically glowed in the dark. Compared to that, nursing scrubs are a dream - comfortable, colorful and loaded with storage space. I have found that despite having the room, many nursing students have no idea what to carry in their pockets. This list is something that I go over with my students on the first day of clinical, and usually several times throughout the semester. By the time they leave me, it usually sinks in.

Ten Things To Keep In Your Scrub Pockets:

1) Scissors: Carry a pair that are small and not pointed. Medical scissors are best because they are easy to clean and curved. These will come in handy to open pills in blister packs or trim arm hair stuck to the tape of an IV, etc.
2) Tape: The most versatile tape is one-inch sized, paper tape. It is easy to tear, "skin friendly" and easy to write on. It can be used to secure or reinforce a loose dressing, make a temporary label, and many other things.
3) Sharpie: It should be BRAND NAME sharpie. Sometimes the no-name brands will either smear or smell too strong. A sharpie is very useful to add dates to supplies, label patient belongings, mark the location of a pulse, etc.
4) Gloves in YOUR SIZE: Carry two or more pairs in the size that fits you best so you can quickly and easily put them on when needed. At Yale, gloves are kept in the hallway and there are no gloves in the patient's room. You don't want to have to leave the room to get gloves.
5) Alcohol swabs: These are very useful and can be used to quickly disinfect many things. For example, to clean your pen, the earpieces or diaphragm of a stethoscope, the telephone receiver on the patient's phone - tons of stuff.
6) A pen light: A pen light is not just for pupils. It is a flashlight that comes in handy when lighting is poor. For example, to find a pill dropped on the floor, inspect skin in hard-to-see areas, check ID bands or IV sites in dark room, etc.
7) Tape measure:  In most places, you'll find them with the dressing supplies. The disposable paper ones are best. You never know what might pop up that will need to be measured - skin breakdown, drainage on a dressing, circumference of a swollen limb, etc.
8) Pens: Carry at least 3 or more cheap, disposable black pens in your pocket.  Pens are always "borrowed" and easily lost. Plus, it's nice to have one available if a visitor, patient, or colleague needs to jot something down.
9) BLANK paper: You should always have something to write on. It can be some sort of stickies, a tiny pad, index cards or whatever. It's important to write down questions, unfamiliar terms, vital signs, measurements, etc. You won't remember everything.
10) Tissues: Trust me on this one. These will come in very handy.

Being well prepared is important in nursing. If you carry these items in your pockets, it will be one less thing to worry about as you go about your day. Nothing is worse than fumbling for something at the wrong moment, or having to run out of the room to fetch something simple. You will look organized and resourceful to others, even if you feel like a nervous wreck on the inside!
 
 
       Even though I have officially graduated from the program, I cannot practice as an FNP. I need to get certified and licensed by the state of Connecticut. Unlike the NCLEX for RNs, there are two different tests that are offered by two different accrediting bodies to obtain certification. Certification by one of the two accrediting bodies is required in 48 of the 50 United States. California and New York do not require certification to practice as an A.P.R.N. I live less than an hour from N.Y.C. and have considered skipping the test and commuting into the city. Unfortunately, even though certification is not required in NY, most of the insurance companies won't pay you unless you're certified. (Making it especially difficult to find a job!).
        I am struggling with the decision of which test to take for accreditation. Most of my classmates are taking both exams - something that every NP I talk to says is a waste of time and money. Most employers don't care who certifies you, as long as you are certified. I too have decided that I would like to be accredited by both bodies. My thinking is that if two similarly prepared NPs are applying for a job, the candidate with two certifications has an edge. At the very least I think it shows ambition and drive - plus a few extra letters after your name. The problem is the added expense and the thought of having to endure taking two exams is almost unbearable.
         The first accrediting body is the American Nurses Credentialing Center (ANCC). This is the larger, more widely recognized accredeting body. They are an extension of the American Nurses Association (ANA). An FNP who passes this exam can use the initials FNP-BC after his/her name. (or ANP-BC for adult nurse practitioners). So far I can tell you that their application is much more involved. There is a 10 question section that must be completed and signed by the program director from my school. I handed it in nice and early to ensure it would be completed. Unfortunately, the only thing I got back was 10 blank questions with a signature on the bottom. Lesson number 1 - make sure the form is actually filled out prior to getting it back. My fault for not checking! Now I need to chase down the director to find out who accredits the FNP program, which classes met each requirement, etc
          The second accrediting body is the American Association of Nurse Practitioners (AANP). Until recently, their accreditation was not recognized by all 50 states. (Their letters are "NP-C" after the APRN's name). Other than a much simpler 2-page application, the AANP is very similar in terms of exam process, level of difficulty and cost. I did, however discover a little bit of a loophole in the process. (My obsessive reading and endless hours of online searching may pay off after all!) It seems that the AANC will grant reciprocity to APRNs accredited by the AANP. In other words, if I take and successfully pass the AANP exam, all I need to do is submit an (abbreviated) application to the ANCC and I will be accredited - NO EXAM REQUIRED. So what I've done so far is submitted my application to the AANP. I haven't done anything with the ANCC.
           The problem I am having is...I am the only one I know, or ever even heard of that has done it this way. It seems like everyone and their mother is taking or has taken the ANCC exam. Am I making a mistake? Am I missing something? I did confirm with BOTH bodies via email the reciprocity thing. The AANP only offers it for NPs who were certified prior to 1995. The ANCC confirmed it and I've downloaded all of the info about it from their site. The information is literally buried on their site and no one ever mentions it - not in the NP program, review courses, review books or on the NP forums. Either I truly am "on to something" here with this reciprocity thing or I am seriously missing something and making a huge mistake. Only time will tell...